Difficulty in Bowel Movement: Constipation

Have you ever had problems in bowel movement with hard stools that are difficult to extrude? If yes, then you must have been constipated. Constipation is simply having a bowel movement that is infrequent averaging to less than 3 times a week. It is also characterized by stools that are dehydrated and hard due to prolonged stay in our large intestines. These two conditions make a constipated person feel bloated, uneasy, and stressed out during attempts to defecate. Many people suffer from this condition including the children, the adult and the elderly. In fact, there are one out of six Americans who are constipated everyday in the United States alone. This costs 725 million dollars yearly both as personal expenses and as funds of the US healthcare department for the laxative use of their citizens.

What causes Constipation?
There are a lot of causes of constipation among children, adults and elderlies. Lack of fluid and fiber intake, sedentary lifestyle, medications, and other diseases more especially, intestinal obstructions are the most common causes.

Lack of water or fluid intake
As the universal solvent, water also softens the stool. It provides moisture and bulk to it while on transit within the intestine. Decreased water or fluid intake will mean a decrease in the water content of the stool. This will make the consistency of the stool hard and dry as our large intestine further absorbs water from it while it is still there. Ten to twelve glasses of water should be taken on a daily basis to have a good and more comfortable bowel movement. Less than this amount will most probably result to a consistency that is hard to release and at times may cause pain while defecating.

Decreased fiber intake
Fiber is a very good source of non nutritional stool baggage. It absorbs water while all the other food stuffs are moving within the intestinal tract. Whenever we take food rich in fiber, the stool that we produce is softer, bulkier and has more water content inside.This will ease the passage of stool from the rectum to the anus. Fiber rich food can be derived from the following sources such as oats, papaya, bran, grains, nuts, as well from the different green leafy vegetables. Supplementary fibers can be derived from pharmaceutical preparations of psyllium and flaxseed. Daily intake of these fiber rich food and supplementation will definitely make the stool large and heavy yet faster and easier to remove .

Sedentary lifestyle
Bowel movement depends on the “peristalsis” or the forward propulsion or movements of the gastrointestinal tract. Those who lack exercise and physical activities have slower peristalsis and have a greater chance of getting the foodstuffs stuck within the length of the food pipes. The greater the time the stool stays in the large intestine, the more it gets dehydrated. And the more sedentary the person is, the greater the time it takes for the stool to be extruded. This accounts for the infrequent bowel movement of once or twice a week, in addition to having a dehydrated stool.

Medications and presence of other diseases
There are medications or drugs that cause profuse urination and slowing down of gastrointestinal movement or motility. Drugs that cause increased urination may make the person dehydrated in general and make the stool also hard.One good example are the different types of “diuretics” that promote water loss to treat hypertension and kidney diseases. Drugs that are considered depressants such as the antianxiety drugs, anticholinergics,and antiallergies/antihistamines cause a significant slowing down of gastroinstestinal motility. Examples include the “diphenhdyramine or benadryl”, “cetirizine” to treat food allergies and hay fever, and “hydroxyzine” to promote sleep, decrease anxiety and skin itchiness. Presence of the other illnesses, diseases such as Hypothyroidism, Diabetes and intestinal obstructions due to cancers and mass also contribute to the difficulty and delays in bowel movement.

What are the dangers of having constipation?
Chronic and severe constipation may cause a lot of complications that are moderate to serious in nature. Aside from the feelings of bloatedness and left lower abdominal pain, serious complications include fecal impaction, obstipation, rectal prolapse, anal fistula and hemmorhoids may develop.

Fecal impaction
This is more commonly present to people who are bedridden or having neurologic deficits like patients suffering from stroke. Fecal impaction happens when a solid feces sticks to the walls of the colon and therefore cannot be extruded through natural effort of defecation. Operative interventions may be required to remove the impacted stool should this be not remedied by enemas, stool softneners and suppositories.

Obstipation
This type of constipation may happen when there is a significant intestinal obstruction in the body. This may be due to twisting of the intestine, inflammation, mass, polyps or even cancer. Vomiting and painful cramps may be experienced aside from constipation. This will complicate the nutritional status and the comfort of the patient and shoud be resolved through surgery immediately.

Rectal prolapse, anal fistula and hemorrhoids
Chronic constipation may cause a trauma to the anus and rectum of the patient. Rectal prolapse is characterized by protrusion of the rectum or any rectal part through the anal orifice or opening. A fistula may develop as a result of tearing of the mucosa of the anus due to a forceful passage of hard feces. Hemorrhoids on the other hand are outpouching anal or rectal veins that are inflamed and painful. This is the most common complication when forceful passing is often attempted for every incident of constipation.

Chronic constipation is also correlated to a higher risk of having colon cancers as the feces and free radicals stay longer in the large intestine. Free radicals may cause any possible alteration in normal cell growth and repair that may lead to unusual tissue mass and cancerous growths.

Is there a way to prevent constipation at home?

Prevention of constipation is easy and can be done at home. It is important to drink at least 10 to 12 glasses of water or fluids everyday, and increase the dietary fiber in every meal that is taken. Should this be impossible, taking fiber supplements like cilium fiber, flaxseed, and oats after meal may help. Exercising at least 30 minutes every other day or three times a week will promote good gastrointestinal movement and fitness. It is also important to avoid drugs that promote development of hard stools and water loss like Iron supplements, diuretics as well as those that depress peristalsis as described above.

Should these measures become ineffective, other remedies may be necessary. Stool softeners, purgatives or laxatives are used to loosen stools. This may be taken both in an oral form and in a suppository form. Examples are magnesium hydroxide and sodium phosphates, as well as lactulose and glycerin. This may cause diarrhea in large amounts. It is not advisable to be taken for a long time as this may make the bowel movement dependent on the laxative and further make it difficult to defecate naturally without it.

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Please note that the information provided on this website is intended for your general knowledge only and is not a substitute for your doctor's medical advice or treatment for your specific medical conditions.